Over the years, the hospital has opened clinics in Russell, Edwards, Harrisville, Antwerp and DeKalb, and has a physician's office at Pine Grove housing complex in Gouverneur. Antwerp and Edwards are the busiest clinics.

"I know that in years past, ancillary services matched the deficit," said Timothy J. Monroe, hospital board chairman. "Now, they're losing money."
Shortfalls from operating the clinics were made up through other services, such as the lab, which is operating at 25 percent of capacity, Mr. Monroe said.

The state Department of Health shut down the lab Sept. 28 because of deficiencies. Although the state later allowed a partial reopening of the lab, the blood bank remains closed and the hospital cannot provide a number of services, such as most surgeries and a maternity ward.

The hospital is working out a management agreement with Canton-Potsdam Hospital, Potsdam, which still must be approved by the National Automatic Sprinkler Pension Fund, the guarantor of $11 million in bonds that financed the hospital's recent addition.

"The Canton-Potsdam people are looking at all the clinics to determine their productivity," said Dr. Monroe, a veterinarian. "United Helpers is overseeing and evaluating the nursing home."
The Russell Health Center will close soon because the nurse practitioner is taking another job. It is not yet known whether it will reopen.

"We haven't made that decision," Dr. Monroe said.

Russell Supervisor Robert C. Best Jr. said he was sorry to hear the news about the clinic.

"It's not that surprising," he said. "Everybody knows the problems they've had."
The town rented the hospital space for the clinic at $650 per month, then lowered the rent to $325 per month to help.

"We're interested in having the clinic," Mr. Best said. "The rent is not a big deal."
However, the town has not received any rent from the hospital for several months.

Dr. Monroe acknowledged the hospital has a number of outstanding bills that it is trying to juggle. It is making payroll, but has asked some salaried employees to wait for their checks.

The Pine Grove office is a likely casualty because it is close to the hospital and the monthly rent is $1,600, Dr. Monroe said.

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